The present invention generally relates to surgical instruments used in surgical procedures, and more particularly to an improved handle that permits various instruments to be releaseably attached for quicker and easier interchange.
The development of newer minimally invasive surgical techniques, such as laparoscopic surgery, have allowed surgeons to successfully perform numerous operative procedures in many instances which in the past required the need for large surgical incisions. In this newer procedure, one or several very small incisions are made in the patient through which various surgical instruments may be used to perform the required surgical procedure. Minimally invasive surgery offers benefits which include creating less trauma to the patient, reducing the risk of post-operative infections, and allowing speedier recovery than conventional surgery with its larger incisions.
Trocars are commonly used in minimally invasive surgeries. They generally consist of a hollow cannula (tube) and an obturator (bladed or pointed piercing device) which are used, in combinat ion, to make a small portal into a patient. The obturator is designed to slide inside the cannula to create a single unit that may be used to penetrate a small incision that has been previously made by a surgeon. Once the trocar has penetrated the patient's body cavity, the obturator is withdrawn while leaving the cannula in position. Various surgical instruments can then be worked through the cannula to perform whatever surgical technique is required.
Trocars are particularly useful in many types of surgery in which a small incision will permit the required surgical procedure to be completed. One such application is in maxillofacial surgery where bone fractures occurring in the maxilla or mandible are stabilized by bone screws and/or bone plates. In this trocar application, drill guides can be inserted through the cannula which allow the surgeon to pre-drill holes in the bone for receiving bone screws. Trocars can also be used with soft tissue retractors, such as cheek retractors which are employed to hold the tissue away from the surgical site so that it does not interfere with fixation of the facial fracture.
The can may be fastened or secured to a handle of some type. This helps the surgeon control the trocar and facilitates the process of both making the initial incision accurately and subsequently working with various instruments in a manner which reduces the chance of the cannula being pulled from the patient's body cavity prematurely.
Handles of the past have typically employed various approaches for coupling the can to the handle. For example, cannulas were often attached in a permanent manner to the handle such as by welding. Semi-permanent type couplings have also been used such as threading the cannula head to the handle, or providing set screws to hold both parts together. U.S. Pat. No. 5,755,721 to Hearn discloses another semi-permanent type of coupling wherein a retaining ring with an internal depression around its circumference is provided that mates with a spring and ball detent on a surgical instrument. The instrument is pushed into the retaining ring until the detent is seated in the depression.
The handle designs of the past have several drawbacks. The permanent type attachment does not allow the surgeon to interchange different kinds or sizes of surgical instruments. This reduced flexibility for the surgeon and increased prices for each trocar unit which must contain both a handle and permanently affixed can. Overall inventory costs are thereby also increased.
Although the semi-permanent type couplings offer interchangeability of surgical instruments, they too have been problematic. Using set screws or threaded coupling of the can to the handle makes changing instruments cumbersome, especially when it must be done during the exigencies of a surgical procedure. While offering improvement, the coupling described in the Hearn patent does not positively lock the cannula to the handle in a manner that requires the surgeon to unlock the cannula from the handle.
Accordingly, there is a need for a handle which allows for improved releaseability and interchangeability of various surgical instruments with the handle while overcoming the problems associated with the foregoing prior art devices.
Retractor members, which in some embodiments may be ring-shaped, may be used to withdraw or hold soft tissue away from a surgical site to prevent injury to the tissue not directly affected by the surgical procedure. For example, a retractor member is sometimes used in maxillofacial medical and dental procedures to retract the cheek of a patient to repair jaw bone fractures by drilling holes in the damaged bone and implanting bone screws, sometimes in combination with bone plates. Retractor members may be mounted on a tubular member, such as a can. The can may be inserted through an incision in the patient's cheek and the retractor member is inserted through a second or other bodily opening, such as the mouth or second incision, and then affixed onto the cannula. The can/retractor member combination, however, has proven difficult for the surgeon to assemble and adjust in situ during the surgical procedure.